How does the environment affect the child in the womb?
For human beings the first year of life calculated from the moment of conception will be the most dangerous period of his/her life. It is not known how many fertilised eggs or embryos are naturally aborted, but the best estimates are close to one half. Thus possibly less than one out of every two pregnancies end with the birth of a healthy baby. This may be due to many reasons, infections, chemicals, mechanical damage, genetic or some other damage either in sperm or egg cell. If the embryo survives until the foetal period (about 8 weeks from conception), his/her chances improve considerably.
Even mommy is an environment
With the exception of genetic defects, all of the other factors are environmental to the embryo or foetus, irrespective of whether they are physical or chemical. Thus any factors that are internal factors for the mother (e.g. diabetes), medicine (e.g. tetracycline antibiotics), or lifestyle related (e.g. alcohol) are environmental factors to the embryo or foetus. Thus though the mother can protect the foetus from many environmental factors, she can also add her own contribution.
The Commission of the European Union emphasized in their SCALE-program that children, born or in the womb, are one major reason why it is essential to be very strict in the regulation of chemicals. This is the reason why the ban of many substances has been insisted by the authorities and the pressure groups. It has been stated that precautionary principle must be applied, if there is no certainty about the level of risk. There are some examples where this reasoning is very clear, e.g. in the maximum limit values set for dioxins. These values have been set mainly on the basis of calculations of the developmental effects of these chemicals in children.
However, the very same Commission did not accept the health arguments when it came to regulating alcohol or tobacco. It forced the Nordic Countries to impose the same lax level of regulation existing in other countries, and declared that the strict policies in these countries were simply trade barriers. For instance, it was not possible to demand that there would be warning labels of health effects placed on the bottles of alcoholic drinks.
There are a few environmental chemicals that have caused birth defects, e.g. heavy metals mercury and lead, PCB-compounds (Yusho-syndrome in 1968), and dioxins (Seveso accident in 1976). All these chemicals are today strictly regulated and the use of many of them has been banned outright. Some medicines can evoke birth defects, e.g. diethylstilbestrol, thalidomide, tetracyclines, high doses of vitamin A, and practically all cancer chemotherapeutic drugs. All physicians are well aware of the need to restrict their use during pregnancy.
Alcohol and tobacco – the worst of all
It has been estimated that alcohol causes foetal alcohol syndrome in between one to five children per one thousand live births. This is a major developmental syndrome – in its more serious forms, it can cause severe mental deficiencies in the affected child. It seems probable that a higher number of children are born with milder forms of this syndrome, but the effects are much harder to detect.
Regular smoking by a pregnant woman decreases the birth weight of her child by approximately 200 grams. This is quite a significant decrease, because birth weight correlates in many ways with subsequent health even during adult life. If there was an "environmental" chemical causing the same degree of effects as alcohol or tobacco smoking, we would be outraged.
Thus alcohol and tobacco are very unique environmental chemicals affecting the unborn child. Society regulates their use by applying completely different norms than for any other chemicals, but to the child in the womb they are no different from the other external poisons. The individual rights of the mother are seen as so important that at most counselling to reduce exposure is viewed as a possibility, but beyond this the threshold for society to take any other significant action is very high. However, if very strict control is deemed necessary to protect children from pesticides, dioxins and heavy metals, it would seem to be logical to apply the same rules with maternal smoking and alcohol use rather than resorting to double standards.
Exposure during pregnancy
The very best advice which can be given to future mothers is to apply zero tolerance during pregnancy and nursing for smoking and using alcohol. Since no safe thresholds are known, the only safe way is to apply zero tolerance. This may sound unreasonable, but professional advice and counselling are crucial, if personal efforts to abstain are not successful.
Perhaps it is best not even to start
Some may feel that this is offensive from a gender equality viewpoint, but girls should be well aware of the above facts, before they start smoking or the use of alcohol. In particular, nicotine creates such a powerful dependence that it may not be so easy to quit smoking if and when she feels like it. Therefore it would be wise to think twice before starting at all.
Some imagined equality or misunderstood feeling of independence should not be a reason to take a risk, which can be passed on to the next generation. Therefore alcohol should not be on sale alongside groceries, and the same holds true for cigarettes. These items should be only sold in special shops with trained personnel where it would be much easier to control their use by minors.
During the last few years, the health risks of tobacco smoking are beginning to be taken seriously. Unfortunately alcohol is almost completely neglected, and the general public does not take seriously its risks. Both items cause developmental risks to the unborn child that are more dangerous than those of any of the present environmental chemicals.
Notes and references
- See the chapter "The precautionary principle – better safe than sorry?"
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